throat cancer

Although there has been a slight increase in human papillomavirus vaccination coverage among adolescents since 2012, a new report from the Centers for Disease Control and Prevention states that vaccine coverage in this population remains “unacceptably low”.

Human papillomavirus (HPV) is the most common sexually transmitted infection in the US. There are more than 150 types of HPV, 40 of which can be contracted through skin-to-skin contact during vaginal, anal or oral sex.

Low-risk HPV types, such as HPV-6 and HPV-11, can cause warts around the genitals or anus. But high-risk types, including HPV-16 and HPV-18, account for approximately 5% of all cancers worldwide.

Specifically, HPV-16 and HPV-18 account for around 70% of all cervical cancers and almost 50% of all vaginal, vulvar and penile cancers. HPV-16 is also accountable for more than 50% of throat cancers.

There are currently two vaccines available for HPV, which are administered in three shots over 6 months. Cervarix and Gardasil are used for the prevention of cervical cancer, while Gardasil can also protect against anal, vulvar andvaginal cancers and genital warts.

The Advisory Committee on Immunization Practices (ACIP) recommends that preteen girls and boys aged 11 or 12 are vaccinated against HPV. The vaccination is also recommended for teenage girls and young women up to the age of 26 who did not receive it when they were younger, and teenage boys and young men up to the age of 21.

HPV vaccination coverage increased in 2012-13, but remains too low

But despite these recommendations, a new report from the Centers for Disease Control and Prevention (CDC) – published in this week’s Morbidity and Mortality Weekly Report – estimates that in 2013, only 57% of girls and 35% of boys ages 13-17 years received one or more doses of the HPV vaccine.

The figures came from results of the CDC’s National Immunization Survey-Teen (NIS-Teen), which includes vaccine information via telephone surveys for adolescents aged 13-17 years from across the US.

The CDC investigators did, however, find that HPV vaccination coverage increased slightly among girls between 2012-13, from 53.8% to 57.3%, although only a third received the complete three doses. Teenage boys saw a greater increase in vaccination coverage, from 20.8% to 34.6%.

But still, the CDC say HPV vaccination coverage among adolescents is too low, particularly when compared with coverage to other vaccination types. For example, another report from the CDC found that almost 86% of adolescents received one dose of the Tdap vaccine last year, which protects against tetanus, diphtheria and whooping cough.

A 10-year national objective in the US – set in 2010 by Healthy People 2020 – is to reach 80% HPV vaccination coverage among adolescents. These latest statistics suggest there is a lot of work to be done. But lead author of the report, Shannon Stokley, assistant director for science at the CDC’s Immunization Services Division, says they also show the 80% vaccination coverage target is realistic:

“The data on missed vaccination opportunities tells us that it is possible. When we look at the most recent cohort of girls that turned 13, 91% of them had a health care encounter where they could have started the HPV vaccine series before their 13th birthday.

Also, 86% of 13-17 year-olds have received the Tdap vaccine. What these numbers tell us is that preteens and teens are getting to the doctor and they are getting vaccinated, but they aren’t always receiving the HPV vaccine.”

Why is HPV vaccination coverage still low?

From NIS-Teen, the CDC investigators were also able to establish some reasons as to why HPV vaccination coverage remains low among adolescents.

They found that clinicians’ recommendations significantly influenced a parent’s decision of whether to have their children vaccinated against HPV.

Of parents whose daughters were vaccinated, 74% said they received a recommendation from their doctor, while 52% of parents who did not have their daughters vaccinated received a doctor’s recommendation. Among parents whose sons were vaccinated, 72% received a recommendation, while only 26% of parents whose sons were not vaccinated received a recommendation.

Based on these findings, Dr. Anne Schuchat, assistant surgeon general and director of CDC’s National Center for Immunization and Respiratory Diseases, believes health care professionals are key in boosting HPV vaccination coverage among adolescents in the US.

“Pediatricians and family physicians are uniquely situated to prevent missed opportunities by giving HPV vaccine during the same visit they give Tdap and meningococcal vaccines,” she adds.

Parents also revealed that concerns over the safety of the HPV vaccine deterred them from vaccinating their children. However, the CDC stress that – after analyzing national postlicensure vaccine safety data – no serious safety concerns have been linked to the HPV vaccine in the 8 years it has been available.

The investigators point out that the most commonly reported side effects of the vaccine include dizziness, fainting, nausea and headache, and injection-site reactions – including pain, redness and swelling.

When we asked Stokely what needs to be done to alleviate parents’ concerns about vaccinating their children against HPV, she replied:

“Parents need to see information in mainstream media that HPV vaccination is very effective at preventing infection with the types of HPV that cause the most cancers. Parents also need to hear that the HPV vaccine is safe and that it is recommended to be given when their children are 11 or 12 years old, before their risk of acquiring an HPV infection increases.”

In conclusion to the report, the CDC say they will continue efforts to team up with state and local immunization programs, cancer organizations, professional organizations and other stakeholders in an attempt to educate parents and health care professionals about the importance of the HPV vaccine, adding:

“Collaborative efforts remain critical to promoting HPV vaccination so that the nation’s adolescents are protected against vaccine-preventable, HPV-associated cancers.”

Earlier this year, Medical News Today reported on a study claiming that two thirds of healthy American adults areinfected with one or more of 109 strains of HPV.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

World-renowned Japanese musician and composer Ryuichi Sakamoto says he has throat cancer and has canceled his scheduled shows and activities.

The Oscar-winning composer and anti-nuclear activist said Thursday that he was diagnosed with oropharyngeal cancer at the end of June.

“After much thought and consideration, I have decided to take time off of work in order to concentrate on treating it,” the 62-year-old said in a statement. “I promise to return after a full recovery.”

According to his management agency Avex Music Creative Inc., Mr. Sakamoto will step down as one of the directors of the Sapporo International Art Festival 2014, scheduled to start next week. He will also cancel live shows including a performance at Park Hyatt Tokyo on July 30.

Avex Music Creative said there is no time frame set for Mr. Sakamoto’s return, and that the artist will “dedicate all his time to treatment.” The agency declined to offer details on the current stage of Mr. Sakamoto’s cancer.

The pioneering musician debuted as a member of Yellow Magic Orchestra in 1978, playing a role in the emergence of electro pop and providing inspiration for a generation of electronic music and hip-hop producers. His creativity and prowess as a keyboard player, producer and composer extends to a large swath of genres and styles from pop rock to bossa nova. He won an Academy Award for composing the score music for Bernardo Bertolucci’s 1987 film “The Last Emperor,” a movie he also appeared in as an actor.

Among international honors bestowed on Mr. Sakamoto, he was named an Officier of the Ordre des Arts et des Lettres from the French government in 2009.

In addition to his work in music, producing and acting, Mr. Sakamoto has been one of the most vocal activists against nuclear power following the Great East Japan Earthquake in 2011.

He has also been a leading figure in recent moves to prevent outdated legislation being used to stop people dancing at nightclubs in Japan.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Jamie Dimon the chief executive of JPMorgan Chase, has throat cancer and will begin treatment shortly at Memorial Sloan Kettering Cancer Center, he said in a note to the bank’s employees and shareholders late Tuesday.

Doctors discovered the cancer at an early stage, Mr. Dimon, 58, said, noting that his condition was “curable.”

After a series of tests, he said the doctors confirmed that the cancer had not spread beyond the “original site” and the adjacent lymph nodes on the right side of his neck.

Mr. Dimon assured employees at JPMorgan, the nation’s largest bank, that the prognosis from the doctors was “excellent.”

Mr. Dimon, who has held the dual roles of chief executive and chairman at the bank since 2006, has been atop JPMorgan longer than any other bank chief.

The announcement of his diagnosis came on Mr. Dimon’s 10-year anniversary at JPMorgan. That tenure, which began when JPMorgan acquired Bank One, has been marked by triumph — the bank emerged from the financial crisis in better shape than its rivals — and by tumult.

The bank has worked to mend its frayed relationships with regulators — a painful reconciliation that cost it roughly $20 billion. In November, JPMorgan reached a record $13 billion settlement with a range of government authorities over its sale of questionable mortgage-backed securities in the lead-up to the financial crisis. The bank also reached a $2 billion settlement over accusations that it failed to sound alarms about Bernard L. Madoff’s Ponzi scheme.

JPMorgan has also been buffeted by the departure of several top executives. In the last two years alone, at least 10 senior executives have left JPMorgan.

Most recently, Michael J. Cavanagh, once considered an heir to Mr. Dimon, left the bank to join the Carlyle Group, a private equity firm.

And like its rivals, JPMorgan, which will report second-quarter earnings on July 15, is grappling with a slowdown in its trading business.

It has been a particularly grueling stretch for trading units across Wall Street. The sluggish trading revenue traces, in part, to a spate of rules passed in the aftermath of the financial crisis.

In the past, banks made some of their riskiest wagers — bets that sometimes translated into rich profits — through trading complex derivatives, bonds and commodities. In the new banking landscape, where interest rates remain persistently low, the role of those businesses has been diminished.

In his annual letter to shareholders in April, Mr. Dimon stressed that despite the “constant and intense pressure,” he was proud of the bank’s resiliency and its resolve. Last year, JPMorgan earned $17.9 billion in profit despite the legal costs.

Mr. Dimon reiterated his faith in the leadership of the bank on Tuesday. He did not outline any plans to cede the reins of the bank while he has treatment — a process that he said should last about eight weeks.

In his note, Mr. Dimon emphasized that the company would “continue to deliver first-class results for our customers.”

The illness of any chief executive naturally prompts questions about who is prepared to take over, at least for a little while. But Mr. Dimon emphasized in his note that he would remain immersed in the day-to-day operations of the bank.

JPMorgan’s board has remained firmly behind Mr. Dimon, redoubling support for him. The board awarded Mr. Dimon $20 million in annual compensation for his work in 2013. The raise came one year after the board had cut his compensation to $11.5 million.

Even before Mr. Dimon’s diagnosis the board agreed on various succession plans.

“The board had already established a short-term, medium-term and longer-term succession plan,” said a JPMorgan spokesman, Joseph Evangelisti.

Among the potential successors, people briefed on the matter said, are Gordon Smith, the head of JPMorgan’s consumer bank, and Mary Erdoes, who runs the asset management business.

The inclusion of Mr. Smith and Ms. Erdoes reflected the changing fortunes of banking. JPMorgan’s consumer business, for example, has taken on more prominence as the bank shifts its focus to credit cards and auto loans and away from intricate deal-making and trades that once were the hallmark of Wall Street.* This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Aerosmith’s Tom Hamilton admits the after effects of cancer treatment came back to ”bite” him.

The bass player, who was told his throat and tongue cancer had returned in 2011, had a difficult year last year after he pulled out of the band’s tour of Australia and was replaced by David Hull due to health issues.

He told digitaljournal.com: ”I had a couple of situations last year that I’m past. Sometimes the after effects of cancer treatment sort of come back to bite you later on down the road. That happened last year, but I’m feeling great now … having an awesome time out here.”

The 62-year-old musician is now looking forward to touring the US with his Aerosmith band mates – Steven Tyler, Joe Perry, Brad Whitford and Joey Kramer – and he realises there might not be many more opportunities to play live which is why the band put their differences aside.

He said: ”I think we all know that we’re nearer the end than the beginning of this whole thing and nobody wants to miss anything – I certainly don’t.

”I don’t want to miss all the amazing stuff there is out in the world for us right now just because of an argument or because somebody is too burned out and they lash out or something. Everything is forgivable when you consider what’s out there for us if we can keep it together…”

Asked if he had considered retiring from the group, he replied: ”Yeah, we have periods when we’re off the road for a few months at a time. But I start to realise that I’m so used to being out on the road that sometimes being at home I feel like I don’t do it right!

”I like having nice long breaks in between tours, but I do get itchy to get back out here, especially knowing that there’s a lot of people that want us. They’re waiting for us to come back. That’s something that’s a joy for us.”

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Walt showed us in Mary Poppins that Mr. Banks could be saved from his work addiction, as demonstrated in Tom Hanks wonderful portrayal in Saving Mr. Banks. However, he could not save Mr. Goff (P. L. Travers’ father) from his alcohol addiction, leading to his fatal infection (influenza, not TB). And Walt, unfortunately, could not save himself.

Not portrayed in the film was the most important lesson Walt taught us. Walt Disney’s fatal illness which shortened his life and deprived us all of his extraordinary imagination and creations was lung cancer directly caused by his life-long chain smoking. When he died at the young age of 65 from lung cancer only 1 month after it was diagnosed, he had left us with the record 59 Oscar nominations and 22 Academy Awards, a record that still has not been broken.

But could Walt have been saved? Smoking is the leading preventable cause of death in America. 392,000 Americans die every year from smoking, including deaths from smoking-induced heart and lung disease and also 160,000 deaths from smoking-related cancers. America’s 43 million smokers have a shortened life, 13.2 years less for men and 14.5 years less for women. Smoking causes not only lung cancer, but also throat, larynx, esophagus, stomach, pancreas, colon, cervix, kidney, bladder and ovary cancer and also leukemia.

And of course, Walt Disney is only one of the well-known celebrities to have died from smoking addiction and then cancer. Lung cancer also claimed the lives of John Wayne, Yul Brynner, Nat King Cole, Duke Ellington, Edward R. Murrow, Steve McQueen, Arthur Godfrey, Pee-Wee Reese, Betty Grable, and Lon Chaney. Throat cancer was fatal for Babe Ruth, Judy Holliday, Sigmund Freud, Edward VIII the Duke of Windsor, and George Harrison who had both lung cancer and throat cancer! Humphrey Bogart succumbed to esophageal cancer from his smoking. And pancreatic cancer from smoking took the lives of Count Basie, Jack Benny, Patrick Swayzee and my patient Michael Landon. Frank Sinatra had bladder cancer.

So we should learn from Walt, and be reminded by all these celebrities, smokers should stop smoking. Smoking cessation is a dream of 69 percent of the 43 million smokers in America. In 2010, 52 percent of them tried stopping smoking for at least 1 day, but most unsuccessfully, tragically. Nicotine, after all, is a highly addictive psychoactive chemical whose habit is tough to break.

But the good news is that comprehensive smoking cessation help and guidance is becoming more successful, is more available, and now is covered by many health insurance plans under the Affordable Care Act (Obamacare). So here are my tips to begin and succeed in stopping smoking:

• If you smoke, discuss cessation with your primary doctor. Expect your physician to give you advice, and a program to help you stop smoking (physicians have guidelines for smoking cessation recommendations). Get a second opinion if he or she does not take the time to do it. See my book Surviving American Medicine for detailed tips about getting second opinions. With your doctor, set a definite date to stop smoking or begin the cessation program
• Get counseling help. This is available as individual counseling (sometimes even with hypnosis), group sessions, by telephone (1-800 QUITNOW), and online. To help you, trusted internet sources include the CDC Smoking Tobacco Use Website, Be Tobacco-Free, Smoke-Free, CDC How To Quit, and a general navigating guide from the CDC.
• Use a nicotine replacement method: this includes gum, patch, nasal spray, inhaler and even e-cigarettes (although e-cigarette consumers are not told what additives are in the nicotine that is vaporized, so there may be some adverse side effects with long term use).
• With your physician, consider using prescription aids to stop smoking such as Zyban or Chantix, but be aware of and watch for the rare side effects.
• Enlist the help of your family and friends. Avoid situations that promote smoking, and choose friends who do not smoke.
• Make a written resolution about smoking cessation, share it with others who will be helping you to avoid smoking (usually family), and keep your pledges.
• If you smoke now or have smoked in the past, begin a program to screen for and diagnose conditions that are smoking-induced. Most of these tests are now covered by insurance. Lung function tests and cardiac evaluations detect emphysema and heart disease. Low dose CT lung scans find small and more curable lung cancers. Small throat cancers are detected by oral and ENT exams. CT scans, urinalyses, and endoscopies of stomach and colon find early cancers caused by smoking. If your doctor is not ordering these tests, get a second opinion from a specialist.

So with what we know today, we could have saved Mr. Disney, and many of the other celebrities. More importantly, you can save your own life by recognizing the problem of smoking addiction and committing yourself to improvement. Build your team to help you, including family, friends and physicians. Too late now to save Mr. Disney, but just in time to save yourself.

* This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Katie Couric’s talk show “Katie” has drawn ire from doctors and journalists for a recent segment on the HPV vaccine that presented what it called “both sides” of the “HPV controversy.”

The segment included personal stories from two moms who claim their daughters suffered serious harm from the vaccine (one of them died). In addition, the show featured two physicians: one who researched the vaccine and thinks its long-term protection benefits are oversold, and one who recommends it to her patients, in line with recommendations from the Centers for Disease Control and Prevention and the American Academy of Pediatrics.

Ahead of the show, which aired Dec. 4, Couric tweeted:

Dr. Arthur Caplan, director of the division of medical ethics at NYU Langone Medical Center in New York City, did not feel it was appropriate to juxtapose the anecdotal stories with the medical evidence. He had hoped more weight would be given to the scientific evidence of the vaccine’s safety profile and effectiveness at preventing cervical cancer.

“The show was kind of inexcusable in terms of damage done versus positive contribution,” he told CBS News.

Any time you’re vaccinating hundreds of thousands of people, Caplan said, you can expect that some people in that population will have health incidents occur. But their ailments may not necessarily be connected to the vaccine. What needs to be weighed is the cause and effect, versus what may be just coincidence. Mentioning such incidents in that context would have been one thing, but giving them more air-time than the bevy of evidence about safety and efficacy is another.

“The problem in TV and all media, (is) the human interest drives the story,” said Caplan. “In science and public health, it doesn’t, or it’s at risk of grave harm.”

“If you want to do a show every day that spotlights anecdotal claims about the health effects of cell phones or curative powers of megavitamins or dangers of airplane contrail vapors, you can certainly fill up lots of programming,” said added. “But I don’t think you’re doing anyone a service.”

While the show has certainly sparked debate, what’s not debatable is that HPV is a significant factor in cancer cases in the United States.

Human papillomavirus, or HPV, is an infection that is so common that it will occur in virtually all sexually-active people at one point or another. About 79 million Americans are currently infected with HPV, according to federal estimates.

There are more than 150 related viruses that make up HPV, but about 40 can be transmitted sexually, and some play a bigger role in causing genital warts while others increase risk for cancers of the cervix, anus, oropharynx (throat and back of the tongue), vulva, vagina and penis.

About 90 percent of genital warts are caused by the HPV 6 and 11 strains, while the majority of cancers related to the infection — about 70 percent — are caused by strains 16 and 18.

But most people won’t have a problem. The CDC points out 90 percent of all HPV infections, including the cancer-causing strains, will be cleared or undetectable in two years without any treatment, with many leaving the body within six months due natural immunity.

It’s the ones that don’t clear that are worrisome. Virtually all cervical cancer cases each year – there are 12,340 new ones expected in 2013 — are caused by high-risk strains of HPV, according to the National Cancer Institute.

Rates of oropharyngeal cancer have soared in recent years, studies have found, and HPV from oral sex is thought to be to blame, as Michael Douglas spotlighted in June by disclosing his throat cancer was caused by the infection.

That’s where vaccines aim to help, by preventing HPV in the first place. The two approved vaccines are Cervarix, which prevents HPV types 16 and 18, and Gardasil, which prevents HPV 16 and 18 as well as the genital-wart causing HPV 6 and 11 strains.

Both vaccines are given in three doses over a six-month period, recommended for females aged 13 through 26, and males between 13 and 21 years old.

“The vaccines that are available right now are one of our only protections against HPV,” Dr. Nieca Goldberg, director of the Joan H. Tisch Center for Women’s Health at NYU Langone Medical Center, told CBS News in June.

A CDC study in June reported rates of HPV strains related to genital warts and some cancers have dropped 56 percent among American teen girls since a vaccine was introduced in 2006, from 11.5 percent of 19-year-olds infected before the vaccine was introduced, to 5 percent by 2010.

Dr. Diane Harper, chair of family medicine at the University of Louisville who researched the vaccine, told Couric that the vaccine’s protection wears off after five years, so men and women could still be at risk for HPV down the road.

The CDC, however, says studies with up to six years of follow-up data have found no evidence of waning effectiveness from the vaccine, a point Caplan also emphasized. One study found even one dose was 82 percent effective, though all three doses are recommended.

The CDC adds that if 80 percent of teens got all three doses of the vaccine, an estimated 53,000 additional cases of cervical cancer could be prevented over the lifetimes of girls aged 12 and older. For every year that increases in coverage are delayed, another 4,400 women will go on to develop the disease.

That’s not to that say the HPV vaccine, or any vaccine, can’t cause side effects.

The CDC’s Vaccine Adverse Event Reporting System (VAERS) has received at least 22,000 reports of adverse events in girls and women who got the vaccine between June 2006 through March 2013. Over this time, about 57 million doses of the vaccine were distributed in the United States.

Ninety-two percent of the reported side effects were considered nonserious. They included injection-site pain and swelling, fainting, dizziness, nausea, headache, fever and hives.

The other almost 8 percent of serious side effects included headache, nausea, vomiting, fatigue, dizziness, fainting and generalized weakness.

Michael Douglas never had throat cancer, as he told the press in 2010.

The actor now says he had tongue cancer. Douglas said he hid the diagnosis at the urging of his doctor to protect his career.

“The surgeon said, ‘Let’s just say it’s throat cancer,’ ” Douglas told fellow actor Samuel L. Jackson for a segment that ran on British television as a part of Male Cancer Awareness Week.

Douglas says that the doctor told him if they had to do surgery for tongue cancer, “it’s not going to be pretty. You could lose part of your tongue and jaw.”

When Douglas first talked about his cancer diagnosis in the summer of 2010, he was on a worldwide publicity tour for the movie “Wall Street: Money Never Sleeps.”

Douglas and Jackson joked that could have been the end of his acting career. Douglas said if he had surgery he could see the director saying, “What’s your good side? I’ve got no side over here.”

“There really is no such thing as throat cancer per se,” explained Brian Hill, an oral cancer survivor and the founder of the Oral Cancer Foundation. Douglas has taped a public service announcement to raise awareness about oral cancer for Hill’s foundation.

“Throat” cancer and tongue cancer are both colloquial terms that fall under the oral cancer umbrella. Throat cancer usually refers to cancerous tumors that develop in your pharynx, voice box or tonsils. Tongue cancer refers to cancerous cells that develop on your tongue.

“The treatment up until just recently can be very brutal,” Hill said of tongue cancer. “Your career as a leading man could be over. If you have signed a contract to promote a movie, you would have a strong motivation not to say … ‘Maybe in six months I won’t have a tongue or lower jaw.’ ”

Douglas apparently did not need the potentially disfiguring surgery. He told Jackson he was instead treated with an aggressive form of radiation and chemotherapy. The treatment, he said, lasted five months.

In June, Douglas kicked off an animated conversation about the cause of oral cancer when he told The Guardian that he got throat cancer after engaging in oral sex. Oral sex can expose individuals to the human papilloma virus, which can cause cancer.

Later, Douglas’ publicist told CNN that Douglas did not blame HPV solely for his cancer; Douglas said he was also a smoker and a drinker. Smoking and drinking, particularly when combined, are considered the most significant contributing factors to oral cancer, according to the Centers for Disease Control and Prevention. So is Douglas’ gender. Men are twice as likely to develop oral cancer as women.

Oral cancers account for 2% to 4% of all cancer diagnoses in the United States. An oral cancer diagnosis is particularly serious; only half of the people diagnosed with oral cancer are still alive after five years, according to the CDC. In large part, that’s because of the late diagnoses of this disease. Most signs of this cancer are difficult to detect and are often painless.

Douglas told Jackson that initially his doctors treated him with antibiotics. Douglas had been complaining of a soreness at the back of his teeth. Three months later when it still hurt, the doctor gave him another round of antibiotics. Nine months later, after talking to a friend who was a cancer survivor, he went to the oncology department where a doctor did an initial exam and then a biopsy. He was diagnosed with stage four oral cancer in 2010.

Douglas is not the first celebrity to misidentify the kind of cancer they have.

Actress Valerie Harper, who first came to fame on the TV show “Mary Tyler Moore,” announced her cancer on the cover of People magazine in March. The story said she had little time left to live and was suffering from terminal brain cancer. It turns out the “Dancing With the Stars” celebrity actually had lung cancer that had spread to the lining of her brain.

“I see a lot of people with ‘brain cancer’ who actually have… lung cancer or breast cancer or some other cancer (that spread) to the brain,” Dr. Otis Brawley, the American Cancer Society’s chief medical and science officer, told CNN. “We treat cancer according to its origin.”

Harper’s kind of cancer, leptomeningeal carcinomatosis, can be slowed but the cells are adaptable and can develop a resistance to treatment. A complete remission is unlikely.

Douglas, on the other hand, has had regular check-ups since the diagnosis. At his two-year mark, he told Jackson, his doctors said he was clear of the cancer.

A vaccine that protects women against cervical cancer also appears to protect them against throat cancers caused by oral sex, and presumably would protect men as well, according to a study released Thursday.

Rates of this throat cancer have soared in the past 30 years, particularly among heterosexual middle-aged men. About 70 percent of oropharyngeal cancers are now caused by sexually transmitted viruses, up from 16 percent in the 1980s. The epidemic made headlines last month when the actor Michael Douglas told a British newspaper that his throat cancer had come from performing oral sex.

Oncologists have assumed that the human papillomavirus vaccine, which is used to prevent cervical cancer, would also prevent this other type of cancer, but this was the first study to provide evidence.

“This is a very nice paper,” said Dr. Marshall R. Posner, medical director for head and neck cancer at Mount Sinai Medical Center in New York, who was not involved in the study. “We expected this — that’s why we want everyone to vaccinate both boys and girls. But there’s been no proof.”

The study, supported by the National Cancer Institute, found that Cervarix, made by GlaxoSmithKline, provided 93 percent protection against infection with the two types of human papillomavirus that cause most of the cancers.

“We were surprised at how big the effect was,” said Dr. Rolando Herrero, head of prevention for the World Health Organization’s International Agency for Research on Cancer, and the study’s lead author. “It’s a very powerful vaccine.”

The study was done with 5,840 women in Costa Rica who were ages 18 to 25 and sexually active when it began. Four years after being vaccinated, each gave a mouthwash gargle sample that picked up cells from deep in the throat. Only one woman who had received the vaccine was infected with the viruses HPV 16 or HPV 18, the cancer-causing types; 15 women who had gotten a placebo vaccine were infected.

Dr. Herrero explained some of the study’s limitations: when it began, it was concerned only with cervical cancer, so no men were enrolled. The women were initially tested to make sure they had no cervical infections, but were not tested for throat or anal infections. They gave oral samples only once, so it was not possible to say how many had persistent infections; most people clear HPV infections on their own, so only a tiny fraction lead to cancer. Four years is not long enough to know how many cancers would develop — but finding out for sure would require waiting 20 years or more, and ethical guidelines require that all women in the trial get regular examinations and that any suspicious lesions be destroyed before they turn cancerous. Also, only Cervarix, and not Merck’s similar Gardasil vaccine, was tested.

However, Dr. Herrero said, men would “probably” get the same protection as the women did, because the vaccine produces identical antibody levels in both sexes.

Dr. Posner said the large discrepancy in infection rates between those who got the vaccine and those who got placebo suggested that the data was “very reliable” even though the infections were detected far too early to produce cancers.

“What we don’t know,” he said, “is how long-term the protection is, or if re-vaccination is necessary.”

While cancers caused by smoking or drinking usually occur in the mouth, those caused by oral sex usually occur at the base of the tongue or deep in the folds of tonsillar tissue, and are hard to detect. They are more common among heterosexual men than among women or gay men; experts believe that is because vaginal fluid contains more virus than the surface of the penis.

Dr. Eric J. Moore, a Mayo Clinic surgeon specializing in these cancers, said the study was “very encouraging.”

“But remember,” he added. “It only works if you’re vaccinated prior to contracting the infection. Once you’re 40 and have had multiple sexual partners, it’s not going to help.”

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Source The New York TimesBy SABRINA TAVERNISEPublished: June 19, 2013 342 Comments

The prevalence of dangerous strains of the human papillomavirus — the most common sexually transmitted infection in the United States and a principal cause of cervical cancer — has dropped by half among teenage girls in recent years, a striking measure of success for a vaccine against the virus that was introduced only in 2006, federal health officials said on Wednesday.

Dr. Judith L. Schaechter gives an HPVvaccination to a 13-year-old girl in heroffice at the University of Miami LeonardM. Miller School of Medicine.

The sharp decline in the infection rate comes at a time of deepening worry among doctors and public health officials about the limited use of the HPV vaccine in the United States. Health departments across the country are scrambling for ways to increase vaccination rates, while nonprofit groups are using postcard reminders and social media campaigns and pediatricians are being encouraged to convince families of the vaccine’s benefits.

There are some signs that resistance to the vaccine may be growing. A study published in the journal Pediatrics in March found that 44 percent of parents in 2010 said they did not intend to vaccinate their daughters, up from 40 percent in 2008. Because it prevents a sexually transmitted infection, the vaccine comes with a stigma. Some parents worry it promotes promiscuity. And it has been controversial. During the Republican primary in 2011, Representative Michele Bachmann, Republican of Minnesota, said the vaccine could have “dangerous side effects,” a concern that health officials say is unfounded.

The magnitude of the decline in HPV infections surprised public health experts because only about a third of teenage girls in the United States have been vaccinated with the full course of three doses. By comparison, vaccination rates in countries like Denmark and Britain are above 80 percent. Even Rwanda, in East Africa, has reached 80 percent.

Yet even with relatively low vaccination rates in the United States, infection with the viral strains that cause cancer dropped to 3.6 percent among girls ages 14 to 19 in 2010, from 7.2 percent in 2006, the officials said.

“These are striking results,” said Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention. “They should be a wake-up call that we need to increase vaccination rates. The bottom line is this: It is possible to protect the next generation from cancer, and we need to do it.”

The findings, published online Wednesday in The Journal of Infectious Diseases, covered the years 2003 to 2010 and were based on a national survey that is conducted every two years and is considered the gold standard on health indicators. Government health workers interviewed more than 8,000 girls and women ages 14 to 59 and collected vaginal swabs that were evaluated by the C.D.C.

The infection rate for girls fell even further when the two strains of the virus that cause genital warts were included, with a 56 percent drop over the period of the study. The rate was flat in the years before the vaccine was introduced, giving researchers even more assurance that the vaccine was driving the decline. Health officials began monitoring HPV prevalence in boys only this year. The first data will be available in 2015.

There are about 12,000 cases of cervical cancer and 4,000 deaths a year in the United States. At current vaccination rates, the vaccine would prevent 45,000 cases of cervical cancer and 14,000 deaths among girls now age 13 and younger over the course of their lifetimes, according to C.D.C. estimates. Increasing the rate to 80 percent could prevent an additional 53,000 cancers and nearly 17,000 deaths.

Federal officials on Wednesday sought to dispel fears about the vaccine, and emphasized its role in preventing cervical cancer.

“This is an anticancer vaccine,” Dr. Frieden said.

About 79 million Americans, most in their late teens and early 20s, are infected with HPV, or about a quarter of the American population. Each year, about 14 million people become infected. The virus causes about 19,000 cancers in women every year, and 8,000 in men, according to the C.D.C. Cervical cancer is the most common among women; among men, throat cancer is most common.

Health officials offered several possible explanations for why the drop was so sharp even though most girls in the United States are still not fully vaccinated.

One possible reason is a phenomenon known as herd immunity, in which people who are vaccinated reduce the overall prevalence of the virus in society, decreasing the chances that unvaccinated people would be exposed to someone who is infected. Another is the unexpected effectiveness of a partial dosage of the HPV vaccine, said Dr. Lauri E. Markowitz, a medical epidemiologist at the C.D.C. and the lead author of the study. About half of teenage girls in the United States have received at least one dose of the vaccine.

Because girls and women who got vaccinated tended to be more sexually active, compared with those who were not vaccinated, researchers suggest that those who had been contributing most to the prevalence of the infection were no longer infecting others.

There are two HPV vaccines, one made by Merck for boys and girls, and one by GlaxoSmithKline, for girls. Experts recommended in 2007 that all girls get vaccinated, and extended that guidance to boys in 2011.

Earlier data from the C.D.C. showed that Hispanic girls were more likely to be vaccinated than white girls, even though they were less likely to come from families with health insurance or to get regular medical care. That is partly because a federal program that covers vaccines for the poor and underserved gave the H.P.V. vaccine to clinics, while many patients with private insurance had high co-pays or had to pay the full price, generally up to $500 for a complete cycle of the vaccine.

But cost will be less of an issue after the full implementation of President Obama’s health care law, which Dr. Frieden said requires providers to cover the vaccine at no cost to patients.

Another obstacle to higher vaccination rates are doctors, who Dr. Frieden said are “not consistently giving strong recommendations for the vaccines, particularly for younger teens.”

Dr. Amanda F. Dempsey, an associate professor of pediatrics at the University of Colorado Denver, says most providers believe in the vaccine, but have met considerable resistance from parents, and feel that the brief time during visits may be better used on topics to which parents are more receptive.

“You want to make the biggest impact,” said Dr. Dempsey, who recommends the vaccine to patients, but still gets a lot of refusals. Many parents do not believe their child is at risk because they are not sexually active, but she said that she explains that vaccination should happen long before exposure.

She added, “For a lot of people there’s still a vague sense that there’s some controversy about the vaccine.”

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Health experts have commended Michael Douglas for speaking out about link between throat cancer and oral sex.

The 68 year-old actor, who endured a six-month battle with the illness, hit headlines over the weekend when he voiced his belief that his cancer was caused by HPV, the human papillomavirus, which can be contracted through oral sex.

The Behind The Candelabra star told Britain’s The Guardian newspaper, “Without wanting to get too specific, this particular cancer is caused by HPV, which actually comes about from cunnilingus… I mean, I did worry if the stress caused by my son’s incarceration didn’t help trigger it. But yeah, it’s a sexually transmitted disease that causes cancer. And if you have it, cunnilingus is also the best cure for it.”

Douglas’ frank admission has now won him praise from Brian Hill, executive director of Oral Cancer Foundation, who tells the New York Post, “I’m really quite proud of Michael saying this. This (oral sex) is not an aberrant sexual behavior. But the willingness to talk about this openly can be difficult.”

The actor recorded a public service announcement for the Oral Cancer Foundation last year.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.